A retrospective observational study of epidemiology, clinical characteristics and outcomes of melioidosis in a tertiary care hospital in Hyderabad

Abstract

Abstract Background: Melioidosis, caused by Burkholderia pseudomallei, is becoming a disease of public health importance. Despite appropriate treatment, the disease is associated with a high mortality due to the non-availability of diagnostic modalities at primary care and due to delayed presentation to the tertiary care hospital. Methods: This is a retrospective observational study of 12 cases of culture-proven melioidosis diagnosed at a tertiary care hospital in Hyderabad in South India over a period of 15 months. This study presents the epidemiology, risk factors, clinical and radiological manifestations and outcomes of patients with culture-proven melioidosis. Results: The study included 12 participants, out of which 11 were male, with a mean age of 39 years. Diabetes mellitus was the most common comorbidity in our series. The most common organs involved were lung (n = 5) and bone (n = 4). The other organs involved were prostate, liver, skin and soft tissue, spleen, aorta, brain, kidney and bone marrow. B. pseudomallei was isolated from pus culture in eight patients, blood cultures in seven patients and bone marrow culture in one patient. Eleven out of 12 patients were treated with meropenem. In our series, 7 out of 12 patients died; thus, a mortality of 58.3% was noted. Conclusions: Melioidosis is an emerging disease in India but remains under-recognised. This study showed that young males with diabetes, working in agricultural fields, are susceptible. Although the clinical manifestations are diverse, melioidosis should be suspected when patients with diabetes present with pneumonia and abscesses.